In healthcare, to provide excellent patient care, strong communication is key. But communication can often be unnecessarily complicated, and procedures are not always standardized. New technology offers new ways to reach people, but rarely works as seamlessly as it should. This can prohibit efficient patient care. But bringing disparate systems together and creating uniform procedures throughout your organization can have a positive impact on communication- The Leading Physicians of The World
Healthcare providers don’t talk to each other enough. Members of the care team—physicians, nurses, social workers and even caregivers—don’t spend enough time communicating with each other about the patient’s needs, and no one from the care team spends enough time communicating with the patient. The increasingly complex needs of patients, an explosion of medical knowledge, and seismic shifts in healthcare systems have set the stage for a need for more effective communication. Additionally, today’s new models of care are focused on maintaining health rather than responding to acute illness. Success demands team-based approaches that are centered on close collaboration among all types of providers from across the care continuum. As a result, achieving the triple aim of improving quality, lowering costs and enhancing the patient experience can only be done with a significantly altered and improved communication strategy.
The statistics cited by the Institute of Medicine (IOM) in a 2012 report illustrate some of the challenges. Every year, the average elderly patient sees 7 physicians (5 specialists and 2 primary care physicians) across 4 different practices. Physicians in private practice caring for Medicare patients interact with as many as 229 other physicians at 117 different practices each year. The average surgery patient is seen by 27 different healthcare providers while in the hospital. One excellent recent illustration of the complexity of patient care came from Dr. Matthew Press, who described the interactions he had on behalf of a patient whom he had referred for tumor resection. Press documented 40 communications with 11 other care providers (9 physicians, a social worker and the lab), while his patient had 5 procedures and 11 office visits over the 80 days from the date of diagnosis until the completion of tumor resection.
Not all of the communication problems in healthcare can be attributed to systemic complexity. Patients struggle to remember what they are told; one study showed that patients only recalled 40% of the information they were given, and almost half of what they thought they remembered was incorrect. Even when they understand the directions, less than half of non-surgical patients follow up with their primary care provider following discharge. Physicians, too, have opportunities to improve an important communication tool, listening: an iconic study by Beckman and Frankel found that physicians interrupted patients’ initial statements 77% of the time, and that the average time to interruption by the physician was a mere 18 seconds.
This culminates in a huge number of missed opportunities to deliver higher-quality and more cost-effective care. That same IOM report estimated that $765 billion of healthcare spending was wasted in 2010, with more than half attributable to unnecessary and inefficiently-delivered services, as well as missed prevention opportunities. While not all of this waste can be ascribed to ineffective or non-existent communication, the data clearly indicate that communication plays a significant role.
Fortunately, the literature is also replete with positive examples of the effects of communication. Improving communication among the care team has been shown to greatly improve the team’s understanding of goals of care and to decrease length of stay. Furthermore, high-quality communication between care team members and patients has been shown to have a positive influence on patient health outcomes.